Findings on a puppy evaluation of a Boston Terrier

[JuliPotter]

I would love your thoughts on this puppy evaluation. I am wondering, when you find changes in puppies and you treat them, how often do you assess them? and do you recommend home exercises based on your findings?
Exam findings for Reese on November 5, 2021
Reese is a 14-week-old female Boston Terrier. Overall, she seems to be doing quite well but I have noticed that she slips easily on the hardwood floors, and she always moves as she defecates. She defecates frequently throughout the day as well (not sure if this could be related to weakness in the rear end) and her stools are normal.
Upon palpation, the first rib on the right appears to be more cranial than the left and she does cry with palpation of this rib. She cries with side glide of C6/C7 on the right and she growled at me with palpation of C6/C7 on the left. Reactions to DV pressure at the curvature of the ribs (#6-10) on the right side, I do get intermittent reactions, she whines or mouths my hands but this is not consistent. There is decreased muscle mass of the right quadriceps and hamstrings compared to the left and I feel like it is easy to move the patella, more so on the right; I did not try to luxate the patella and pup does squirm with palpation. The wing of the ilium is more cranial and dorsal on the right and Reese does seem painful with palpation of the Sacrotuberous ligament as well as the Piriformis on both the right and left sides, she whines and moves away.
Thank you so much,
Juli

[lehughes]

Hey Juli,

Okay, that's a lot for a puppy!!!

I've only ever seen one other 1st rib on a wee puppy (7 - 8 weeks)... and it was associated with a salivary gland infection as he was growing.

In a case such as what you mention, I would recommend seeing that pup within a week to 10 days. That's a lot going on in a growing body. I think it's imperative to catch the issues, treat the issues, and make sure things stay happy as the dog is growing.

Exercises are tough, as puppies often don't have the coordination for exercises that we might prescribe if this were an older dog... BUT, it's not too early to start with 3 leg stands. Hill walking is also an easy way to try to gain rear limb strength in a safe and puppy appropriate way.

It might also be wise to encourage the laying down of non-slip mats for a while. And stretching scalenes and cookie exercises for the neck / 1st rib.

Monitor if your treatment has any bearing on the 'defecation dilemmas'. Interesting!

Cheers!

Laurie

[JuliPotter]

Thank you so much, Laurie!
I am looking forward to monitoring Reese to see how she progresses!
because she is a wiggly girl, I do wonder about the changes in symmetry I am seeing with the Ilium but with the consistent reactivity to palpation of the sacrotuberous ligament and piriformis, I feel this is real. I do see her chewing one of her back feet at night as well; not sure if this is related but I will continue to monitor this.
I will keep you posted on Reese! She is my puppy! My sweet Penelope died suddenly in September! I was in total shock and am still devastated by her loss! I just want/need one healthy Boston Terrier who won't break my heart and leave me so soon!

Laurie, I think I would like to try to find a way to do exams on as many puppies as I can (maybe partnering with a local colleague) and see what MSK changes I find in these pups! (So wish I had your experience though) I am wondering, would it be possible to learn what others are finding on puppy/litter evaluations as well? How do I access this information?
Instead of trying to tie in a behavior component, I think it would be easier just to compile information (my own and others) and write a paper as a way to create awareness! What do you think? Then I will focus my Master's project on pain and behavior and I can tie in the importance of early recognition and treatment.

As always, I truly appreciate your insight and your knowledge!
Sincerely and with much gratitude,
Juli

[lehughes]

Hey Juli,

So firstly, my condolences on the loss of Penelope. I know how dedicated you were to all aspects of her wellbeing.

As for your puppy, Reese. The piriformis and sacrotuberous pain are real. Puppies don't lie. It'll be SIJ... and you'll need to fix it! Keep going!

And in regards to your litter evaluation study... NOW I think you're talking! I think to report on litter findings would be fabulous. Not sure how many folks are doing them... but my clinic would be willing to participate in the study and provide data on SEVERAL litter evaluations. If you create some sort of an information document (i.e. what you want / contact info / etc.), I can send it out via FourLeg and target some of the FB groups.

Laurie

[JuliPotter]

Laurie,
Thank you so much for your kindness and compassion!

and thank you as well for your insight and encouragement with Reese! It is time for me to do her recheck! I am somewhat concerned about the consistent neck pain...I have done low grade mobilizations/side glide but I am having a hard time with traction for her...I just have to go very slow, but she loves the cookie stretches!

And, Thank you so much, Laurie! I just spoke to my advisor and she said that I can do this project on reporting puppy/litter eval findings first and then potentially link this to my next project on pain and behavior! I will start working on writing something up for the info I would like to collect and get back to you soon!
You are wonderful! I appreciate you so very much!
and I will keep you posted on how Reese is doing!
Juli

[JuliPotter]

Laurie, I did email you my list of questions and will include them here as well, with one edit.
I am wondering if you think I should try to present these in a more formal way such as with a survey? also, would it help to put an age limit? say up to 6 months?
I am open to (and appreciative of) any feedback you may have!
Thank you so much! Your assistance and encouragement means so very much to me!
Juli

Information requested for puppy/litter evaluation study-
Age, sex, weight, and breed of puppy
Was there a history of trauma or possibly a traumatic birth prior to evaluation?
Were there any other medical or behavioral concerns noted during the initial evaluation
How many pups are in the litter and of these pups, how many showed changes on the evaluation
Exam findings on initial exam
Exam findings on follow up exams, if done
Treatments, including home exercise program for each pup and was a recheck recommended
Were any of these pups evaluated as they got older, if so, for how long and what were the findings?
Do you have a standard protocol for puppy/litter evaluations? Is there a checklist used for the exam?

And I will need to list the name of the clinic and physiotherapist who provided information on the puppy/litter evaluations. If you could kindly provide your information, your name and name of the clinic, I would appreciate it!

Thank you so much for your help!
Juli
Juli Potter, DVM, CCRT, Master’s student (OMALS) in Applied Animal Behavior and Welfare, VPI & SU
#703-927-1824
Email- julis6pack@msn.com
pmargar@vt.edu

[lehughes]

For this part of the discussion... let's email back and forth.
(Sorry, I'm so tardy! I don't know how MORE piles on when I am trying to have less pile on!)

I have to have a bit of time to digest what you are asking and/or think about what is most logical / practical in regards to a study.

I was thinking of just sending you our puppy evaluation notes (black out anything personal) and let you sort through them to see what correlations you can make. (And yes, provide qualifications of persons doing the evaluations... etc.)

So hang onto that thought... or put in my thought to your thought...
I'm thinking that if you want participation from other practitioners, you want to make it easy for them.
AND as a survey, I would have to answer it multiple times per litter. So maybe there is a survey to find out about the practitioner doing the evaluations (qualifications, years in practice, advanced training, etc...), and his/her thoughts, views, assumptions, etc. and anything they might want to share.
All in all, you have a bit of a qualitative study with a bit of quantitative thrown in to be able to reflect numbers of puppies, numbers of findings, and of what type.

Cheers,

Laurie

[JuliPotter]

Thank you so much, Laurie!! I feel that I am pretty naïve when it comes to research and study design so thank you so much for your patience and your help!
If you don't mind, I would like to give you an update on Reese....I am concerned about her neck pain. With her recheck today, she is quite reactive with side glide at C6/7 bilaterally and with palpation of the first rib, also bilaterally, she whines, growls and tries to bite my hand and besides typical puppy biting, this is very unusual. I wonder if the reactivity of the first rib is related to pain at C6/7. I attempted to treat with side glide and she will not let me! I have tried traction as well but she has to be sleepy for me to do this. Though she still has SIJ dysfunction, she was most reactive with strumming of the piriformis bilaterally but not the sacrotuberous ligament, and I am able to do thigh thrust (bilaterally) and caudal and dorsal translation (on the right) without incident. Just yesterday, I read your blog about the diaphragm and C6/7 pain; I am wondering if diaphragm release may be a way to help with her neck pain, and I do apologize if this is a stupid question but I was thinking that laser therapy would be helpful as well....but are there any contraindications for laser therapy in a 4 month old pup?
Once again.....Thank you so much!
Juli

[lehughes]

Hi Juli,

So, I would speculate that the 1st rib issues are correlated with the neck pain - so I'd focus on the neck. If you aren't able to to touch C6/7, then work on T1/2 and C4/5. You will still have an impact on C6/7 and can revisit the exact spot later. As well, there is no harm in assessing / treating the diaphragm.

I would laser the neck without concern.

And perhaps try gapping at the SIJ.

Best of luck!

Laurie

[JuliPotter]

Thank you so much, Laurie!
You are the best!!
Juli